[Cancer of the vulva. Diagnostic and therapeutic aspects apropos of a series of 90 cases].

The authors present a series of 90 cases of cancer of the vulva of which 10 were intra-epithelial and 80 were invasive. These were studied from the 1st January 1962 through to the 31st December 1980. The mean age was 70.04 years, the range being from 31 to 92 years of age. Most cases however were between the ages of 70 and 80. 37.7% of the patients were debilitated. The condition was brought to notice by the discovery of a tumour in 48.8% of the cases, the onset of pruritus in 20% of cases and pain in 14.4%. Most of the tumours were found on the labia majora and minora (in 52.2%). FIGO classification was of stage I in 12% of cases, stage II in 26.6%, stage III in 33.3% and stage IV in 28%. The methods for treating these conditions have been shown according to whether the tumour was intra-epithelial or invasive. Analysing the results confirms that this kind of cancer has a poor prognosis: 57.6% of survivors after 2 years but only 37.3% after 5 years (an actuariel calculation). 30 cases of relapses were analysed and also the complications that occurred. Among these were most frequently (25%) lymphocoeles, sutures falling out because of necrosis and infection (34.2%), urinary incontinence (35.2%). The circumstances in which the patients died were determined above all by the way the disease evolved locally, but in 13.3% of the cases there was metastatic disease. Finally, the difficulties of the diagnosis and of the definition of micro-invasive cancer of the vulva are commented on. The authors point out that the prognosis depends as much as anything on the amount the lymphatics are involved, the frequency and the problems of therapy that are posed by urinary incontinence which occurs after operation. They then give their ideas for treating the patients.